Prognostic Factors Associated With Survival in Patients With Diffuse Astrocytoma

Background: Diffuse astrocytoma (DA) is a rare disease with inadequately understood epidemiological characteristics and prognosis. Identification of the factors associated with the survival in DA patients is therefore necessary. In this study, we aim to investigate the clinicopathological characteristics of DA to delineate factors influencing the survival of DA.Methods: A population-based cohort study was conducted, utilizing prospectively extracted data from the Surveillance, Epidemiology and End Results (SEER) database. Patients with histological diagnosis of DA in the SEER database from 1973 to 2017 were included.Results: A total of 799 participants with DA were included, consisting of 95.9% fibrillary astrocytoma and 4.1% protoplasmic variants. The average age of participants was 41.9 years, with 57.2% being male. The majority of the population was white (87.5%). More than half (53.9%) of the patients were married. DA arose mostly in the cerebrum (63.8%). Around 71.6% of the population had received surgical treatment. The overall 1-, 3-, 5-, and 10-year survival rate were 73.7, 55.2, 49.4, and 37.6%, respectively. Kaplan–Meier analysis showed that age at diagnosis, marital status, primary tumor site, tumor size, and surgery was possibly associated with cancer-specific survival (CSS) (p < 0.05). Multivariate Cox proportional hazard analysis indicated that surgery was a protective factor whereas older age, larger tumor size, and tumor in the brainstem were harmful factors for patients with DA. Moreover, a nomogram predicting 5- and 10-year survival probability for DA was developed.Conclusions: Age, primary tumor site, tumor size, and surgery were associated with the survival of patients with DA.

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Do Metastatic Kidney Cancer Patients Benefit From Cytoreductive Nephrectomy? A Real-World Retrospective Study From the SEER Database

Frontiers in Surgery ◽

10.3389/fsurg.2021.716455 ◽

2021 ◽

Vol 8 ◽

Author(s):

Cheng Li ◽

Ruiliang Wang ◽

Wenchao Ma ◽

Shenghua Liu ◽

Xudong Yao

Keyword(s):

Surgical Resection ◽

Kidney Cancer ◽

Real World ◽

Primary Tumor ◽

Target Therapy ◽

Tumor Site ◽

Seer Database ◽

Cytoreductive Nephrectomy ◽

Cancer Specific Survival ◽

Primary Tumor Site

Introduction: The benefit of cytoreductive nephrectomy (CN) for metastatic kidney cancer has been challenged recently. The study aimed to evaluate the prognostic roles of surgical resection of primary tumor site for metastatic kidney cancer under a real-world setting.Methods: The Surveillance, Epidemiology, and End Results (SEER) database (2010–2015) and the overall survival (OS) and cancer-specific survival (CSS) were evaluated using the Cox proportional hazards regression model. One-to-one matching using the propensity score was used to estimate and compare the survival rates.Results: The SEER data contain records of 8,932 patients from 2010 to 2015. The data showed that 61.7% of the patients underwent CN while 38.2% did not receive any surgery. The median survival month for a patient without surgery was 4 months and for a patient with surgery was 19 months. The multivariate analysis showed that surgical resection of the primary tumor site was an independent favorable predictor for both OS and CSS (all p < 0.001) in the original and the matching cohort.Conclusions: In the era of target therapy, CN might still be a vital method to treat metastatic kidney cancer.

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Prognostic Factors for Children and Adolescents With Surgically Resected Nonrhabdomyosarcoma Soft Tissue Sarcoma: An Analysis of 121 Patients Treated at St Jude Children's Research Hospital

Journal of Clinical Oncology ◽

10.1200/jco.1999.17.12.3697 ◽

1999 ◽

Vol 17 (12) ◽

pp. 3697-3705 ◽

Cited By ~ 114

Author(s):

Sheri L. Spunt ◽

Catherine A. Poquette ◽

Yasmeen S. Hurt ◽

Alvida M. Cain ◽

Bhaskar N. Rao ◽

...

Keyword(s):

Prognostic Factors ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Tumor Size ◽

Primary Tumor ◽

Distant Recurrence ◽

High Grade ◽

Tumor Site ◽

Primary Tumor Site ◽

Positive Surgical Margins

PURPOSE: The rarity and heterogeneity of pediatric nonrhabdomyosarcoma soft tissue sarcoma (NRSTS) has precluded meaningful analysis of prognostic factors associated with surgically resected disease. To define a population of patients at high risk of treatment failure who might benefit from adjuvant therapies, we evaluated the relationship between various clinicopathologic factors and clinical outcome of children and adolescents with resected NRSTS over a 27-year period at our institution. PATIENTS AND METHODS: We analyzed the records of 121 consecutive patients with NRSTS who underwent surgical resection between August 1969 and December 1996. Demographic data, tumor characteristics, treatment, and outcomes were recorded. Univariate and multivariate analyses of prognostic factors for survival, event-free survival (EFS), and local and distant recurrence were performed. RESULTS: At a median follow-up of 9.2 years, 5-year survival and EFS rates for the entire cohort were 89% ± 3% and 77% ± 4%, respectively. In univariate models, positive surgical margins (P = .004), tumor size ≥ 5 cm (P < .001), invasiveness (P = .002), high grade (P = .028), and intra-abdominal primary tumor site (P = .055) adversely affected EFS. All of these factors except invasiveness remained prognostic of EFS and survival in multivariate models. Positive surgical margins (P = .003), intra-abdominal primary tumor site (P = .028), and the omission of radiation therapy (P = .043) predicted local recurrence, whereas tumor size ≥ 5 cm (P < .001), invasiveness (P < .001), and high grade (P = .004) predicted distant recurrence. CONCLUSION: In this largest single-institution analysis of pediatric patients with surgically resected NRSTS, we identified clinicopathologic features predictive of poor outcome. These variables should be prospectively evaluated as risk-adapted therapies are developed.

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Risk factors for osteoradionecrosis of the jaw in patients with head and neck squamous cell carcinoma

10.21203/rs.3.rs-63024/v2 ◽

2020 ◽

Author(s):

Hikaru Kubota ◽

Daisuke Miyawaki ◽

Naritoshi Mukumoto ◽

Takeaki Ishihara ◽

Megumi Matsumura ◽

...

Keyword(s):

Risk Factors ◽

Squamous Cell Carcinoma ◽

Oral Cancer ◽

Cell Carcinoma ◽

Head And Neck ◽

Primary Tumor ◽

Tooth Extraction ◽

Tumor Site ◽

Primary Tumor Site ◽

Factors Associated

Abstract Background: To evaluate factors associated with osteoradionecrosis of the jaw (ORNJ) in patients with head and neck squamous cell carcinoma (HNSCC), focusing on jaw-related dose-volume histogram (DVH) parameters.Methods: We retrospectively reviewed the medical records of 616 patients with HNSCC treated with curative-intent or postoperative radiation therapy (RT) during 2008–2018. Patient-related (age, sex, history of smoking or alcohol use, diabetes mellitus, performance status, pre-RT dental evaluation, pre- or post-RT tooth extraction), tumor-related (primary tumor site, T-stage, nodal status), and treatment-related (pre-RT surgery, pre-RT mandible surgery, induction or concurrent chemotherapy, RT technique) variables and DVH parameters (relative volumes of the jaw exposed to doses of 10 Gy–70 Gy [V10–70]) were investigated and compared between patients with and without ORNJ. The Mann–Whitney U test was used to compare RT dose parameters. Univariate and multivariate Cox regression analyses were used to assess factors associated with ORNJ development. Kaplan–Meier analyses were performed for cumulative ORNJ incidence estimation. Results: Forty-six patients (7.5%) developed ORNJ. The median follow-up duration was 40 (range, 3–145) months. The median time to ORNJ development was 27 (range, 2–127) months. DVH analysis revealed that V30-V70 values were significantly higher in patients with than in those without ORNJ. In univariate analyses, primary tumor site, pre-RT mandible surgery, post-RT tooth extraction, and V60 >14% were identified as important factors. In multivariate analyses, V60 >14% (p=0.0065) and primary tumor site (p=0.0059) remained significant. The 3-year cumulative ORNJ incidence rates were 2.5% and 8.6% in patients with V60 ≤14% and >14%, respectively (p<0.0001), and 1.4% and 9.3% in patients with oropharyngeal or oral cancer and other cancers, respectively (p<0.0001). Conclusions: V60 >14% and oropharyngeal or oral cancer were found to be independent risk factors for ORNJ. These findings might be useful to minimize ORNJ incidence in HNSCC treated with curative RT.

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Identifying Benefit Factors Associated With Primary Tumor Resection in Patients With Stage IV Gastric Cancer: a Propensity Score-matched Analysis

10.21203/rs.3.rs-622860/v1 ◽

2021 ◽

Author(s):

Haihao Yan ◽

Zheng Liu ◽

Ye Jin

Keyword(s):

Gastric Cancer ◽

Primary Tumor ◽

Histological Grade ◽

Stage Iv ◽

Tumor Site ◽

Primary Tumor Site ◽

Stage Iv Gastric Cancer ◽

Factors Associated ◽

T Stage ◽

Surgery Group

Abstract Background: At present, the beneficial factors related to surgery at the primary tumor site in patients with stage IV gastric cancer (GC) are unclear. We developed a new selection process to determine the beneficial factors associated with primary tumor surgery.Methods: Patients with stage IV GC were screened from the Surveillance, Epidemiology, and End Results (SEER) database and were divided into surgery and non-surgery groups. The Kaplan-Meier method was used to estimate the survival curve before and after the propensity score-matched analysis (PSM). We believe that patients in the surgery group who have a longer median cancer-specific survival (CSS) time than those in the non-surgery group can benefit from surgery. Use Multivariate Logistic regression analysis to determine the benefit factors related to surgery.Results: A total of 7259 patients with stage IV GC were included, of which 29.95% (2174) underwent primary tumor surgery. After PSM, the median CSS of the surgery group and the non-surgery group was 12 months and 7 months, respectively (p < 0.001). Multivariate COX regression analysis showed that age, T stage, primary tumor site, histological classification, histological grade, and chemotherapy were independently correlated with CSS. We included the independent related factors affecting CSS in COX analysis in the multivariate Logistics regression model. The results showed that T stage, histological grade, and chemotherapy were related to surgical benefit.Conclusion: The surgery to the primary tumor site can prolong the survival time of patients with stage IV GC, and surgeons should screen patients before surgery. Our results show that patients with T stage T4b and histological grade GIII/GIV do not benefit from surgery, while patients receiving chemotherapy can benefit from surgery.

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Risk Factors for Osteoradionecrosis of the Jaw in Patients With Head and Neck Squamous Cell Carcinoma

10.21203/rs.3.rs-63024/v1 ◽

2020 ◽

Author(s):

Hikaru Kubota ◽

Daisuke Miyawaki ◽

Naritoshi Mukumoto ◽

Takeaki Ishihara ◽

Megumi Matsumura ◽

...

Keyword(s):

Risk Factors ◽

Squamous Cell Carcinoma ◽

Oral Cancer ◽

Cell Carcinoma ◽

Head And Neck ◽

Primary Tumor ◽

Tooth Extraction ◽

Tumor Site ◽

Primary Tumor Site ◽

Factors Associated

Abstract Background: To evaluate factors associated with osteoradionecrosis of the jaw (ORNJ) in patients with head and neck squamous cell carcinoma (HNSCC), focusing on jaw-related dose-volume histogram (DVH) parameters.Methods: We retrospectively reviewed the medical records of 616 patients with HNSCC treated with curative-intent or postoperative radiation therapy (RT) during 2008–2018. Patient-related (age, sex, history of smoking or alcohol use, diabetes mellitus, performance status, pre-RT dental evaluation, pre- or post-RT tooth extraction), tumor-related (primary tumor site, T-stage, nodal status), and treatment-related (pre-RT surgery, pre-RT mandible surgery, induction or concurrent chemotherapy, RT technique) variables and DVH parameters (relative volumes of the jaw exposed to doses of 10 Gy–70 Gy [V10–70]) were investigated and compared between patients with and without ORNJ. The Mann–Whitney U test was used to compare RT dose parameters. Univariate and multivariate Cox regression analyses were used to assess factors associated with ORNJ development. Kaplan–Meier analyses were performed for cumulative ORNJ incidence estimation. Results: Forty-six patients (7.5%) developed ORNJ. The median follow-up duration was 40 (range, 3–145) months. The median time to ORNJ development was 27 (range, 2–127) months. DVH analysis revealed that V30-V70 values were significantly higher in patients with than in those without ORNJ. In univariate analyses, primary tumor site, pre-RT mandible surgery, post-RT tooth extraction, and V60 >14% were identified as important factors. In multivariate analyses, V60 >14% (p=0.0065) and primary tumor site (p=0.0059) remained significant. The 3-year cumulative ORNJ incidence rates were 2.5% and 8.6% in patients with V60 ≤14% and >14%, respectively (p<0.0001), and 1.4% and 9.3% in patients with oropharyngeal or oral cancer and other cancers, respectively (p<0.0001). Conclusions: V60 >14%, and oropharyngeal or oral cancer were found to be independent risk factors for ORNJ. These findings might be useful to minimize ORNJ incidence in HNSCC treated with curative RT.

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Risk factors for osteoradionecrosis of the jaw in patients with head and neck squamous cell carcinoma

Radiation Oncology ◽

10.1186/s13014-020-01701-5 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Hikaru Kubota ◽

Daisuke Miyawaki ◽

Naritoshi Mukumoto ◽

Takeaki Ishihara ◽

Megumi Matsumura ◽

...

Keyword(s):

Risk Factors ◽

Squamous Cell Carcinoma ◽

Oral Cancer ◽

Cell Carcinoma ◽

Head And Neck ◽

Primary Tumor ◽

Tooth Extraction ◽

Tumor Site ◽

Primary Tumor Site ◽

Factors Associated

Abstract Background To evaluate factors associated with osteoradionecrosis of the jaw (ORNJ) in patients with head and neck squamous cell carcinoma (HNSCC), focusing on jaw-related dose–volume histogram (DVH) parameters. Methods We retrospectively reviewed the medical records of 616 patients with HNSCC treated with curative-intent or postoperative radiation therapy (RT) during 2008–2018. Patient-related (age, sex, history of smoking or alcohol use, diabetes mellitus, performance status, pre-RT dental evaluation, pre- or post-RT tooth extraction), tumor-related (primary tumor site, T-stage, nodal status), and treatment-related (pre-RT surgery, pre-RT mandible surgery, induction or concurrent chemotherapy, RT technique) variables and DVH parameters (relative volumes of the jaw exposed to doses of 10 Gy–70 Gy [V10–70]) were investigated and compared between patients with and without ORNJ. The Mann–Whitney U test was used to compare RT dose parameters. Univariate and multivariate Cox regression analyses were used to assess factors associated with ORNJ development. Kaplan–Meier analyses were performed for cumulative ORNJ incidence estimation. Results Forty-six patients (7.5%) developed ORNJ. The median follow-up duration was 40 (range 3–145) months. The median time to ORNJ development was 27 (range 2–127) months. DVH analysis revealed that V30–V70 values were significantly higher in patients with than in those without ORNJ. In univariate analyses, primary tumor site, pre-RT mandible surgery, post-RT tooth extraction, and V60 > 14% were identified as important factors. In multivariate analyses, V60 > 14% (p = 0.0065) and primary tumor site (p = 0.0059) remained significant. The 3-year cumulative ORNJ incidence rates were 2.5% and 8.6% in patients with V60 ≤ 14% and > 14%, respectively (p < 0.0001), and 9.3% and 1.4% in patients with oropharyngeal or oral cancer and other cancers, respectively (p < 0.0001). Conclusions V60 > 14% and oropharyngeal or oral cancer were found to be independent risk factors for ORNJ. These findings might be useful to minimize ORNJ incidence in HNSCC treated with curative RT.

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Impact of Primary Tumor Size on Prognosis in Patients With Metastatic Renal Cell Carcinoma Receiving Cytoreductive Nephrectomy: A Population Study of a Chinese Center and the US SEER Database

Technology in Cancer Research & Treatment ◽

10.1177/15330338211019507 ◽

2021 ◽

Vol 20 ◽

pp. 153303382110195

Author(s):

Weixing Jiang ◽

Jianzhong Shou ◽

Hongzhe Shi ◽

Li Wen ◽

Huijuan Zhang ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Prognostic Factors ◽

Tumor Size ◽

Primary Tumor ◽

Protective Factor ◽

Seer Database ◽

Cytoreductive Nephrectomy ◽

Small Tumor ◽

Chinese Cohort ◽

Small Tumor Size

Background: The relationship between the size of the primary tumor and the prognosis of patients with metastatic renal cell carcinoma (mRCC) is unclear. In this study, we aimed to investigate the significance of the size of the primary tumor in mRCC. Methods: We retrospectively reviewed the data of patients with mRCC who underwent cytoreductive nephrectomy (CN) from 2006 to 2013 in a Chinese center (n = 96) and those in the Surveillance, Epidemiology, and End Results (SEER) database (from 2004 to 2015, n = 4403). Tumors less than 4 cm in size were defined as small. Prognostic factors were analyzed using univariate and multivariate Cox proportional hazards regression analyses. Results: Patients with small tumors had a longer overall survival than other patients, both in the Chinese cohort (median, 30.0 vs 24.0 months, P = 0.026) and the SEER cohort (median, 43.0 vs 23.0 months, P < 0.001). After adjusting for other significant prognostic factors, small tumor size was still an independent protective factor in the Chinese cohort (adjusted hazard ratio [HR], 0.793; 95% confidence interval [CI]: 0.587–0.998, P = 0.043). In the SEER cohort, multivariate analysis showed that small tumor size was also an independent protective factor (HR, 0.880; 95% CI: 0.654–0.987, P = 0.008). In addition, as a continuous variable, a 1 cm elevation in tumor size translated into a 3.8% higher risk of death (HR, 1.038; 95% CI, 1.029–1.046; P < 0.001). Conclusion: Patients with small tumors may have a favorable prognosis after CN for mRCC. Although CN is not a standard protocol in mRCC, small tumor size may be a candidate when we are deciding to perform CN because of the potential benefit for OS.

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Comparison of treatment regimens for pediatric lymphoblastic non-Hodgkin's lymphoma: a Childrens Cancer Group study.

Journal of Clinical Oncology ◽

10.1200/jco.1995.13.6.1368 ◽

1995 ◽

Vol 13 (6) ◽

pp. 1368-1376 ◽

Cited By ~ 77

Author(s):

D G Tubergen ◽

M D Krailo ◽

A T Meadows ◽

J Rosenstock ◽

M Kadin ◽

...

Keyword(s):

Primary Tumor ◽

Hodgkin’S Lymphoma ◽

Myelogenous Leukemia ◽

Hodgkin's Lymphoma ◽

Tumor Site ◽

Primary Tumor Site ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma ◽

Localized Disease ◽

Extent Of Disease

PURPOSE Patients with lymphoblastic non-Hodgkin's lymphoma (LB NHL) were randomized to treatment with either modified LSA2L2 or ADCOMP, which added daunorubicin (DAUN) and asparaginase (L-ASP) to the methotrexate (MTX), cyclophosphamide (CYT), vincristine (VCR), and prednisone (PRED) (COMP) regimen, in a clinical trial to determine the relative effectiveness and toxicity of the two regimens. PATIENTS AND METHODS Patients with LB NHL were eligible for this randomized study if they were less than 22 years of age at diagnosis and had < or = 25% blasts in the bone marrow. Of 307 patients registered, 281 were fully eligible and assessable. Patients were stratified by extent of disease at diagnosis. RESULTS The 5-year event-free survival (EFS) rate for patients with localized disease was 84%, and for patients with disseminated disease, 67%. There were four relapses in 28 patients with localized disease. Two hundred six patients had mediastinal primary tumors and despite local radiation, 34 of 63 failures in these patients involved the primary tumor site with or without other involvement. After adjusting for extent of disease at diagnosis, the regimens did not differ significantly with respect to risk for adverse events. The acute toxicity was primarily neutropenia and thrombocytopenia, with greater initial toxicity in patients on the LSA2L2 regimen. Three patients developed acute myelogenous leukemia. CONCLUSION Long-term EFS in children with LB NHL can be achieved in the majority of patients. Disease progression, which includes recurrence at the primary tumor site, is a major cause of treatment failure in patients with mediastinal presentations. Addition of DAUN and L-ASP to the COMP regimen does not produce a more effective treatment than LSA2L2.

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A phase II/III randomized double-blind study of octreotide acetate LAR with axitinib versus octreotide acetate LAR with placebo in patients with advanced G1-G2 NETs of non-pancreatic origin (AXINET trial-GETNE-1107).

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.3_suppl.360 ◽

2021 ◽

Vol 39 (3_suppl) ◽

pp. 360-360

Author(s):

Rocio Garcia-Carbonero ◽

Marta Benavent ◽

Paula Jiménez Fonseca ◽

Daniel Castellano ◽

Teresa Alonso ◽

...

Keyword(s):

Disease Progression ◽

Phase Ii ◽

Primary Tumor ◽

Phase Iii ◽

Study Entry ◽

Tumor Site ◽

Double Blind ◽

Primary Tumor Site ◽

Octreotide Lar ◽

Octreotide Acetate

360 Background: Angiogenesis plays an important role in NET development and progression. Axitinib is a potent and selective VEGFR-1,2,3 inhibitor, with proven activity against several vascular-dependent solid tumors. The aim of this randomized, double-blind phase II/III study was to assess the efficacy of axitinib in patients with advanced G1-2 extra-pancreatic NETs. Methods: Eligible pts were randomized (1:1) to receive octreotide LAR (30 mg IM q4w) with axitinib (5 mg BID) or placebo BID until disease progression or unacceptable toxicity. Pteswere stratified by time from diagnosis to study entry ( > or < 12m), primary tumor site (GI tract vs non-GI) and Ki-67 index (< 5% vs > 5%). Prior therapy with SSA, IFN and up to 2 lines of systemic treatment was allowed, but not prior VEGF- or VEGFR-targeted drugs. Clinical and/or radiological disease progression within 12 months prior to study entry was required. The primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival (OS), time to progression, overall response rate (ORR), duration of response, biochemical response and safety. Results: 256 pts were randomized (106 in the Phase II part, and 150 additional pts in the Phase III part), 126 to axitinib and 130 to placebo. The main characteristics of the study population were: median age 61 years (range: 21-85), 52% male, PS 0-1 (64-35%), G1-2 (29%-71%), primary tumor site GI (40%)-Lung (17%)-Other (32%). Prior therapies included: SSA (46%), everolimus (13%), chemotherapy (13%), TACE (5%) and PRRT (2%). ORR was significantly higher in axitinib- vs placebo-treated patients (17.5% vs 3.8%, p = 0.0004). PFS per investigator assessment also favored axitinib vs placebo-treated patients, although the difference did not reach statistical significance (median PFS 17.2 vs 12.3 months, respectively, HR 0.816, p = 0.169). Grade 3-4 treatment-related AEs occurred more frequently in the axitinib vs placebo arm (52% vs 13.8%), and included hypertension (21% vs 6 %), cardiac disorders (3.2% vs 0.7%), diarrhoea (13% vs 1.5 %), asthenia (9% vs 3%) and nausea&vomiting (2% vs 0.7%). There were 3 treatment-related deaths, 1 in the axitinib arm (cardiac failure) and 2 in the placebo arm (myocardial infarction and hepatorenal syndrome). Conclusions: Although the study failed to demonstrate a significant PFS benefit per investigator assessment, axitinib in combination with octreotide LAR demonstrated activity and had a tolerable safety profile in patients with advanced G1-2 extra-pancreatic NETs. Data base cleaning and central blinded radiological PFS assessment are currently ongoing. Clinical trial information: NCT01744249.

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